The present invention generally relates to surgical instrumentation and procedures. More particularly, the invention relates to smoke evacuators for use in surgery.
In a variety of surgical and dermatological procedures, diseased or other tissue is destroyed as part of the operative procedure. In many cases, the tissue is destroyed by applying heat via a hot needle or laser beam to the tissue causing the tissue to be burned away. For example, warts and tumors can be removed in this manner. This procedure typically results in smoke being produced at the operative site as the tissue is destroyed.
For example, smoke plumes are generated during the dermatological procedure for ablation of verrucae. During the procedure, a laser beam is directed to the patient's skin, and as the tissue is destroyed, a plume rises from the destroyed tissue.
The health risks from inhaling the smoke generated during an operative procedure are not known. However, the smoke particulates are small enough in size to potentially cause lung and eye irritation. The long term effects of such irritation are also unknown. But, it is known that the smoke particulates may include viable viral contaminants as well as destroyed tissue.
There have been some attempts at providing smoke evacuation equipment. However, most of the efforts in this area have concentrated on filtering systems for filtering the smoke once it has been captured, rather than devices for capturing the plumes.
In a current practice, a nurse or assistant holds a suction tube adjacent an operative site to suck in the plume. During the procedure, the nurse or assistant attempts to follow the surgeon's hand with the suction tube to collect as much of the plume as possible.
It was reported in one study that "the amount of matter escaping into the air can be significantly increased if the suction apparatus is not closely approximated to the exposed tissue." J. Garden et al., Papillomavirus in the vapor of carbon dioxide laser-treated verrucae, JAMA 1988; 259:1199-1202.
From the results of this study, it can be inferred that, to provide for successful smoke evacuation adjacent an operative site, the suction apparatus must be as close as is feasible to the source of the plume. This close distance must be maintained throughout the operative procedure.
In laser surgery, the crucial responsibility of holding the suction wand has generally been placed fully on the free hand of the nurse or assistant who also has the simultaneous responsibility of operating the laser. This dual responsibility contributes to ineffective plume evacuation because the nurse's or assistant's attention is divided, and there is the possibility that the nurse or assistant can tire. Thus, in this method there is a great opportunity for the plume to escape.